Axne, Fitzpatrick Lead Call for Expanded Telehealth Services for Seniors during COVID-19 Pandemic

Bipartisan letter to CMS seeks to ensure coverage for the full range of essential hearing, speech, and language services

Today, Rep. Cindy Axne (IA-03) and Rep. Brian Fitzpatrick (PA-01) led a letter with 32 other colleagues to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, urging her to expand Medicare telehealth coverage of valuable audiology and speech-language pathology during the coronavirus (COVID-19) pandemic. 

“At a time when individuals with hearing, communication, and swallowing disorders face even higher risk for isolation and depression, Medicare beneficiaries must have access to appropriate diagnostic and therapeutic services via telehealth to slow transmission of COVID-19 and ensure they receive medically necessary treatment to meet their functional goals,” the members wrote. “We strongly encourage you to issue such guidance to add further audiology and speech-language pathology codes to the authorized telehealth services list.”

The letter was endorsed by the American Speech-Language-Hearing Association, Academy of Doctors of Audiology, American Academy of Audiology, and the ALS Association.

“We appreciate Congress providing CMS the authority to remove barriers that have historically prevented Medicare beneficiaries from accessing audiology and speech-language pathology services safely and effectively through telehealth,” said Theresa H. Rodgers, MA, CCC-SLP, 2020 president of the American Speech-Language-Hearing Association (ASHA). “Unfortunately, the current list of approved audiology and speech-language pathology telehealth services does not adequately cover the full range of medical needs of America’s seniors, including evaluation and treatment for common conditions such as hearing, balance, neurodegenerative and other conditions. ASHA applauds Representatives Axne and Fitzpatrick for their leadership in encouraging the agency to improve seniors’ access to necessary telehealth services during the public health emergency.” 

During the coronavirus pandemic, Rep. Axne has consistently advocated for allowing Iowans to access more medically necessary services through telehealth, which is critical to making sure Iowans can receive care while preventing transmission of COVID-19. 

In April, Rep. Axne introduced the bipartisan Emergency COVID Telehealth Response Act to ensure that physical therapists, occupational therapists, speech pathologists, audiologists, and clinical social workers can receive telehealth reimbursement rates from CMS.

Following Rep. Axne’s push, CMS announced an expansion and clarification of telehealth coverage for four of these key therapeutic services.

In May, Rep. Axne unveiled the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, bipartisan legislation that would commission studies by the Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) to gather information on telehealth use during COVID-19 in order to support making telehealth options and adjusted reimbursement rates permanent.

The full text of today’s letter can be found below.

Dear Administrator Verma:

We are writing to share our support for allowing additional audiology and speech-language pathology services that are already covered under Medicare to be available to beneficiaries via telehealth for the duration of the Coronavirus 2019 (COVID-19) public health emergency (PHE).

We appreciate that the Centers for Medicare & Medicaid Services (CMS) has provided new authority and flexibility for Medicare beneficiaries to receive essential health care services via telehealth by utilizing Section 3703 of the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116-136), including enabling audiologists and speech-language pathologists (SLPs) to provide Medicare Part B telehealth services during the PHE. Unfortunately, the current list of approved telehealth services does not adequately ensure Medicare beneficiaries have access to the range of clinically appropriate hearing, speech, language, cognition, and swallowing services they require. 

There are a number of audiology and speech-language pathology services that can be provided under Medicare in-person that can also be provided remotely in a safe and effective manner. We recommend adding to the telehealth services list audiology codes representing core diagnostic tests for identifying the type, severity, and etiology of hearing loss or the need for further vestibular testing. We also recommend adding to the telehealth services list speech-language pathology codes representing evaluation and treatment of a broader range of speech, language, cognitive, and swallowing disorders, as well as those that relate to evaluating and treating individuals who need speech-generating devices.  

At a time when individuals with hearing, communication, and swallowing disorders face even higher risk for isolation and depression, Medicare beneficiaries must have access to appropriate diagnostic and therapeutic services via telehealth to slow transmission of COVID-19 and ensure they receive medically necessary treatment to meet their functional goals. We understand that CMS can issue sub-regulatory guidance to provide better access to telehealth services for Medicare beneficiaries who need the services of audiologists and SLPs. We strongly encourage you to issue such guidance to add further audiology and speech-language pathology codes to the authorized telehealth services list for its duration as soon as possible.

Again, thank you for your significant efforts to expand telehealth options for Medicare beneficiaries during the PHE. We look forward to the addition of all clinically appropriate audiology and speech-language pathology services to the telehealth services list as soon as possible to build on those efforts.